Neonatal mortality in Edward Francis Small Teaching Hospital, Banjul, The Gambia, 2021: A need for neonatal mortality surveillance

Abstract

Introduction: Neonatal mortality surveillance has not been prioritised in The Gambia, despite the global target of the SDGs to reduce the neonatal mortality rate to <12/1000 live births by 2030. The neonatal mortality rate in The Gambia is 29/1000 LBS. We conducted this study to describe the epidemiology of neonatal mortality at Edward Francis Small Teaching Hospital in The Gambia from January to December 2021. Methods: We conducted a cross-sectional study at EFSTH among neonates who died within the period under study. We extracted data from various sources in the hospital. We analyzed demographic variables, listed sources of data, and determined risk factors for death at a 95% confidence interval. Results: Of the 306 neonatal deaths in 2021, 161 (52.6%) were males; the median age was 2.4 days, with a range of 0.04-26 days. The neonatal mortality rate in EFSTH for the year was 69/1000 LBS. Spontaneous vaginal delivery was the mode of delivery for 242 (79.1%) of the neonates that died in the hospital. There were more than 174 (56.9%) preterm and 95 (35.3%) very low birth weight babies among the deaths. The leading cause of death was pneumonia among 89 (29.1%), while the least common cause of death was asphyxia, accounting for 22 (7.2%) deaths. Conclusion: We found that the neonatal mortality rate for the hospital is higher than the national one. More male neonates died, and the majority of mortalities occurred within the first day of life. More deaths occurred in the Western Regions. The leading cause of death among neonates was found to be pneumonia due to meconium aspiration or as a complication leading to respiratory distress syndrome, among others.